Food insecurity and limited healthy food access are complex public health issues and warrant multi-level evaluations. The purpose of this paper was to present the overall study design and baseline results of the multi-pronged evaluation of a healthy food access (i.e., Fresh for Less (FFL)) initiative in Central Texas. The 2018–2021 FRESH-Austin study was a natural experiment that utilized a cluster random sampling strategy to recruit three groups of participants (total n = 400): (1) customers at FFL assets, (2) residents that lived within 1.5 miles of an FFL asset, and (3) residents from a comparison community. Evaluation measures included annual cohort surveys, accelerometers and GPS devices, store-level audits, and built environment assessments. Data are being used to inform and validate an agent-based model (ABM) to predict food shopping and consumption behaviors. Sociodemographic factors and food shopping and consumption behaviors were similar across the three groups; however, customers recruited at FFL assets were lower income and had a higher prevalence of food insecurity. The baseline findings demonstrate the need for multi-level food access interventions, such as FFL, in low-income communities. In the future, ABM can be used as a cost-effective way to determine potential impacts of future large-scale food environment programs and policies.
Background Go! Austin/Vamos! Austin (GAVA) is a coalition-led health initiative that targets low-income communities with disparities in access to healthy food and physical activity . The purpose of this initiative was to increase healthy eating and physical activity among residents by facilitating access to food and physical activity opportunities through environmental and policy changes. Although GAVA is ongoing, this paper describes the original GAVA intervention and the 5-year evaluation study (2013–2018), presenting selected baseline data obtained through its cohort sub-study. Methods To assess the impact of GAVA, the evaluation plan included multiple sub-studies and involved collection of quantitative, qualitative, and observational data at different levels. The main cohort sub-study followed 313 parent-child dyads over 5 years. Annually, parents completed self-administered surveys regarding awareness and use of community assets/resources as well as their diet and activities. Heights and weights also were measured. Results Cohort participants were primarily Hispanic (87%), very low-income (77%), and food insecure (58%), with high overweight/obesity prevalence among both parents (81%) and children (41%). Awareness and use of community physical activity and healthy eating resources were low, and reported barriers to using these resources were many. Engagement in physical activity and healthy eating also was low. Conclusions Given the baseline statistics, GAVA resident teams chose and implemented strategies to address the noted barriers and low usage of community resources. This approach built community capacity and governance. Both the GAVA intervention approach and evaluation protocol can serve as models for other community initiatives to be implemented in other locations and contexts.
Objectives To describe outcomes of a 4-year physical activity (PA) and nutrition intervention (2013–2017) in Dove Springs, a low-income urban community in Texas. Method Go! Austin/Vamos! Austin is a place-based intervention targeting the built and social environments of PA and nutrition. Baseline and follow-up measures related to PA and nutrition were obtained from 357 parent–child dyads (final n = 236) in the intervention community and a control community. A three-level dose of exposure measure was created to indicate the amount of exposure to intervention activities across the 4 years. Pre–post changes in key outcomes by level of exposure and contrasts across “high exposure” and “no exposure” categories were obtained using repeated-measures regression, adjusting for important confounders. Results “High exposure” adult participants showed consistently more favorable changes than “no exposure” participants across a variety of indicators, including positive perceptions and utilization of community PA resources, amount of moderate PA, utilization of retail outlets offering fresh produce, and measures of healthy eating. Few improvements were seen in child-level outcomes. Conclusions Community interventions can successfully improve health-promoting behaviors provided they ensure sufficient dose of exposure.
The growing frequency and intensity of extreme weather events have placed cities at the forefront of the human, social, economic, and ecological impacts of climate change. Extreme heat, extended freeze, excessive precipitation, and/or prolong drought impacts neighborhoods disproportionately across heterogenous urban geographies. Underserved, underrepresented, and marginalized communities are more likely to bear the burden of increased exposure to adverse climate impacts while simultaneously facing power asymmetries in access to the policy and knowledge production process. Knowledge co-production is one framework that seeks to address this convergence of disproportionate climate impact exposure and disenfranchised communities. Co-production is increasingly used in sustainability and resilience research to ask questions and develop solutions with, by, and for those communities that are most impacted. By weaving research, planning, evaluation, and policy in an iterative cycle, knowledge and action can be more closely coupled. However, the practice of co-production often lacks reflexivity in ways that can transform the science and policy of urban resilience to address equity more directly. With this, we ask what kind of co-production mechanism encourage academic and non-academic partners to reflect and scrutinize their underlying assumptions, existing institutional arrangements, and practices? How can these efforts identify and acknowledge the contradictions of co-production to reduce climate impacts in vulnerable communities? This paper presents a framework for reflexive co-production and assesses three modes of co-production for urban resilience in Austin, Texas, USA. These include a multi-hazard risk mapping initiative, a resident-driven community indicator system for adaptive capacity, and a neighborhood household preparedness guide. We establish a set of functional and transformational criteria from which to evaluate co-production and assess each initiative across the criteria. We conclude with some recommendations that can advance reflexive co-production for urban resilience.
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